Analysis Of Influencing Factors On The Occurrence And Prognosis Of Brain Edema After Surgical Clipping Of Ruptured Aneurysms

Objective To analyze the related factors affecting brain edema in patients with aneurysmal subarachnoid hemorrhage after aneurysmal clipping and the prognosis of patients with cerebral edema.Methods A retrospective analysis was made of 199 patients with aSAH who underwent microsurgical clipping surgery in neurosurgery department of our hospital from December 2016 to December 2017.According to the occurrence of brain edema after operation,the patients were divided into brain edema group(99 cases)and non-brain edema group(100 cases).General data of patients were collected,including sex,age,history of hypertension,smoking history,blood pressure at admission,Hunt-Hess grade,Fisher grade,aneurysm location,aneurysm size,surgical approach,length of operation,whether bone flaps were removed,and mRS score 14 days after operation.Imaging data were collected including CT and CTA images.Do univariate and multivariate regression analysis.Results Univariate analysis showed that the occurrence of brainedema was correlated with blood pressure at admission,Hunt-Hess grade,Fisher grade,length of operation,whether bone flaps were removed and CTA cerebral venous filling defect phenomenon(P < 0.05).Multivariate regression analysis showed that blood pressure at admission,Fisher grade(≥Ⅲ-grade),length of operation,whether bone flaps were removed and cerebral venous filling defect phenomenon may be the independent risk factors for brain edema(P < 0.05).The early prognosis of patients with brain edema after operation was correlated with gender,smoking history,Hunt-Hess grade,Fisher grade and cerebral venous filling defect phenomenon(P < 0.05).Male,Fisher grade(≥Ⅲ-grade)and cerebral venous filling defect phenomenon may be independent risk factors for poor early prognosis of patients with brain edema after operation(P < 0.05).Conclusion Patients with high blood pressure at admission,Fisher grade(≥Ⅲ-grade),long operation time,bone flap removal and cerebral vein filling defect phenomenon are more likely to suffer from brain edema after aneurysm clipping.Those with male,Fisher grade(≥Ⅲ-grade)and cerebral vein filling defect phenomenon are more likely to suffer from poor early prognosis.